Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention
Background: Despite recent advances in interventional equipment and techniques, the angiographic no-reflow phenomenon occurs in a considerable number of patients undergoing primary percutaneous coronary intervention (PCI). We investigated the clinical, angiographic, preprocedural, and procedural cha...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Tehran University of Medical Sciences
2018-07-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/743 |
| _version_ | 1818113954235285504 |
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| author | Mohammad Alidoosti Reza Lotfi Masoumeh Lotfi-Tokaldany Ebrahim Nematipour Mojtaba Salarifar Hamidreza Poorhosseini Arash Jalali |
| author_facet | Mohammad Alidoosti Reza Lotfi Masoumeh Lotfi-Tokaldany Ebrahim Nematipour Mojtaba Salarifar Hamidreza Poorhosseini Arash Jalali |
| author_sort | Mohammad Alidoosti |
| collection | DOAJ |
| description | Background: Despite recent advances in interventional equipment and techniques, the angiographic no-reflow phenomenon occurs in a considerable number of patients undergoing primary percutaneous coronary intervention (PCI). We investigated the clinical, angiographic, preprocedural, and procedural characteristics associated with the no-reflow phenomenon among patients undergoing primary PCI.
Methods: Between March 2008 and April 2013, 530 patients (78.5% male, mean age=58.11±12.39 y) with ST-segment-elevation myocardial-infarction who underwent primary PCI were categorized in 2 groups according to their postprocedural thrombolysis-in-myocardial infarction (TIMI) flow grades: those with a maximum score of 2 (the no-reflow or slow-flow group) and the ones with a score of 3 (the reflow group). A multivariable logistic regression model was used to find the multiple correlates of the no-reflow phenomenon after PCI.
Results: There were 166 (31.3%) patients in the no-reflow group and 364 (68.7%) in the reflow group. The no-reflow patients were older and had significantly longer target lesion lengths, higher SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) scores, higher infarct-related artery SYNTAX scores, more thrombus burden, and a higher frequency of initial TIMI flow grades of 2 or lower. Our multivariable logistic regression analysis demonstrated that older age, higher numbers of Q waves, not using statin, longer target lesion lengths, higher thrombus grades, and higher infarct-related artery SYNTAX scores remained the independent correlates of increased no-reflow rates after primary PCI (area under the ROC curve=0.784, 95% CI: 0.742–0.826; P<0.001).
Conclusion: Clinical, angiographic, and procedural features of patients undergoing primary PCI may be correlated with the occurrence of the no-reflow phenomenon. The thrombus grade and the infarct-related artery SYNTAX score could be among these factors. |
| first_indexed | 2024-12-11T03:43:02Z |
| format | Article |
| id | doaj.art-8ba254961de74ad7896c19dd1c68aed9 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-12-11T03:43:02Z |
| publishDate | 2018-07-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-8ba254961de74ad7896c19dd1c68aed92022-12-22T01:22:06ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712018-07-0113310.18502/jthc.v13i3.130Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary InterventionMohammad Alidoosti0Reza Lotfi1Masoumeh Lotfi-Tokaldany2Ebrahim Nematipour3Mojtaba Salarifar4Hamidreza Poorhosseini5Arash Jalali6Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Background: Despite recent advances in interventional equipment and techniques, the angiographic no-reflow phenomenon occurs in a considerable number of patients undergoing primary percutaneous coronary intervention (PCI). We investigated the clinical, angiographic, preprocedural, and procedural characteristics associated with the no-reflow phenomenon among patients undergoing primary PCI. Methods: Between March 2008 and April 2013, 530 patients (78.5% male, mean age=58.11±12.39 y) with ST-segment-elevation myocardial-infarction who underwent primary PCI were categorized in 2 groups according to their postprocedural thrombolysis-in-myocardial infarction (TIMI) flow grades: those with a maximum score of 2 (the no-reflow or slow-flow group) and the ones with a score of 3 (the reflow group). A multivariable logistic regression model was used to find the multiple correlates of the no-reflow phenomenon after PCI. Results: There were 166 (31.3%) patients in the no-reflow group and 364 (68.7%) in the reflow group. The no-reflow patients were older and had significantly longer target lesion lengths, higher SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) scores, higher infarct-related artery SYNTAX scores, more thrombus burden, and a higher frequency of initial TIMI flow grades of 2 or lower. Our multivariable logistic regression analysis demonstrated that older age, higher numbers of Q waves, not using statin, longer target lesion lengths, higher thrombus grades, and higher infarct-related artery SYNTAX scores remained the independent correlates of increased no-reflow rates after primary PCI (area under the ROC curve=0.784, 95% CI: 0.742–0.826; P<0.001). Conclusion: Clinical, angiographic, and procedural features of patients undergoing primary PCI may be correlated with the occurrence of the no-reflow phenomenon. The thrombus grade and the infarct-related artery SYNTAX score could be among these factors.https://jthc.tums.ac.ir/index.php/jthc/article/view/743Myocardial infarctionPercutaneous coronary interventionNo-reflow phenomenon |
| spellingShingle | Mohammad Alidoosti Reza Lotfi Masoumeh Lotfi-Tokaldany Ebrahim Nematipour Mojtaba Salarifar Hamidreza Poorhosseini Arash Jalali Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention Journal of Tehran University Heart Center Myocardial infarction Percutaneous coronary intervention No-reflow phenomenon |
| title | Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention |
| title_full | Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention |
| title_fullStr | Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention |
| title_full_unstemmed | Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention |
| title_short | Correlates of the “No-Reflow” or “Slow-Flow” Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention |
| title_sort | correlates of the no reflow or slow flow phenomenon in patients undergoing primary percutaneous coronary intervention |
| topic | Myocardial infarction Percutaneous coronary intervention No-reflow phenomenon |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/743 |
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